RESUMO
Objective: To determine the complete clinical response in rectal carcinoma after neoadjuvant chemo radiation
Study Design: Cross-sectional study
Place and Duration of Study: This study was conducted in Clinical Oncology department, Jinnah Postgraduate Medical Centre Karachi, from Jan 2016 to Jan 2017
Material and Methods: Seventy Two Patients meeting the inclusion criteria were enrolled in study after complete staging workup. Neoadjuvant concurrent chemoradiotherapy was planned, consisting of oral capecitabine 825mg/m2 BID five days a week along with 50.4 Gy Radiotherapy with linac machine. Radiation was delivered over a period of 5 weeks at a rate of 1.8 Gy/day. Patients received Radiotherapy in Atomic Energy Medical Centre [AEMC] and in Sindh Institute Urology and Transplant [SIUT], Radiation department. Chemotherapy was given in clinical oncology department of JPMC. Sixty one patients completed planned treatment and were available for post concomitant chemo radiotherapy response assessment with Pelvic CT/MRI after 6-8 weeks of completion of concomitant chemo radiotherapy. Response assessment was done according to Response Evaluation Criteria in solid tumor [RECIST] criteria version 1.1 and then Patients were referred for surgical evaluation
Result: A total of 61 cases of locally advanced adenocarcinoma rectal cancer patients were included in the study.Mean age of the patients was 41 years with +/- 17.06 years SD. Complete clinical response was identified in 4 [6.6 percent] while 31 [50.8 percent] were identified as partial response, progressive disease was 13 [21.3 percent] and 13 [21.3 percent] were with stable disease. All confounding variables were found statistically significant with p-value found less than 0.05
Conclusion: Neo-adjuvant chemoradiotherapy for locally advanced rectal cancer is associated with high rates of tumor response in terms of downs tagging [complete and partial] and is relatively safe with acceptable morbidity, which favors its use in future